卫生资源配置决策的非正式制度的影响研究——基于对隐性优先分配规则的思考  

The Impact of Informal Institutions on Health Resource Allocation Decision Making——Reflections on the Implicit Priority Setting Rules

作　　者：峗怡 Wei Yi

机构地区：[1]西南政法大学政治与公共管理学院,副教授重庆401120

出　　处：《中国行政管理》2019年第3期99-103,共5页Chinese Public Administration

基　　金：国家社科基金青年项目"卫生资源优先次序分配的伦理机制及评价研究"(编号:13CZX082);2018年重庆市社科规划项目"重庆精准健康扶贫的地方政府治理效果评价研究"(编号:2018PY59);西南政法大学2018年度校级科研项目"重庆农村健康扶贫创新研究"(编号:2018XZQN-42)

摘　　要：健康中国2030成为十三五及更长时期的重大国家战略,卫生资源配置决策则是国家卫生治理战略的重要环节。卫生资源优先次序分配不可避免,特别是卫生需求大而国家卫生总费用较少的国家。资源分配决策的优先规则受到一个社会所认同和秉持的价值观影响。多数国家的卫生决策优先规则是隐秘的,这些优先分配潜规则形塑了分配决策的非正式制度,嵌入并影响国家卫生正式制度,共同决定了卫生资源的优先分配。隐性优先分配规则的显化,有助于回应优先分配所面临的伦理抉择冲突,并让实践遵从卫生系统的价值指引。通过比较多种卫生资源优先分配规则,探寻我国适切的优先规则,旨在为健康中国进程中的卫生善治提供伦理基础和价值判断。Healthy China 2030 has become a key national strategy since the 13^th Five-Year Plan, and the health resources allocation decision making is vital for the national healthy strategy .The priority setting in health resource is unavoidable especially in the countries with larger health demand but less domestic health resources, while the rationing priority rules is often influenced by a social common sense and values.The priority rules for health decision-making in most countries are implicit rather than explicit, while the implicit rules shape the potential informal system embedded in and influence the formal national health system, and together affect the health rationing. The extemalization of implicit priority setting rules helps to settle the ethical conflicts in rationing, and further clarifies the implementation path to the value guidance in the health system. Through the comparative analysis of priority rules and related outcome, the possible priority rule for China's health rationing was proposed, which provide an ethical foundation and value reference for good governance of implementing healthy China plan.

关 键 词：非正式制度 卫生资源配置 优先次序 分配规则 

分 类 号：D035[政治法律—政治学]